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General NPI Number Information
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NPI Number | 1801414446
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Entity Type | Individual
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Provider Name | HARUNA KIBUNDILA MALIANI PMHNP-C
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Gender | Male
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Dates
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Enumeration Date | 07/09/2020
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 30 MASSACHUSETTS AVE STE 201
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City | NORTH ANDOVER
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State | MA
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Zip | 01845-3458
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Country | US
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Telephone | 617-596-0601
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1715
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City | ANDOVER
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State | MA
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Zip | 01810-0029
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Country | US
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Telephone | 617-596-0601
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN278416
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License Number State | MA
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